Abstract
The retina, unique in its design and function, is a fragile neural tissue, easily injured and possessing only modest capabilities for repair. Understanding the diffuse nature of retinal injuries requires an appreciation for distinct mechanisms of trauma. The mechanisms of traumatic injury of the retina are numerous and can be categorized into those resulting from sharp or lacerating forces, those associated with blunt force (contusion or rupture), those resulting from acceleration or deceleration forces, and other more complex mechanisms including vascular and photic injuries. The most common traumatic retinopathies involve contusion-related closed globe injuries, which induce mechanical changes of the globe configuration from blunt impact. While our ability to manage severe ocular injuries has certainly improved in the past 50 years, involvement of the retina continues to be an ominous sign, portending a guarded visual prognosis.
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References
Negrel AD, Thylefors B. The global impact of eye injuries. Ophthalmic Epidemiol. 1998;5:143–69.
Kuhn F, Morris R, Witherspoon CD, Mann L. Epidemiology of blinding trauma in the United States eye injury registry. Ophthalmic Epidemiol. 2006;13:209–16.
Kuhn F. Ocular Traumatology. Berlin/Heidelberg: Springer; 2008.
Iftikhar M, et al. Changes in the incidence of eye trauma hospitalizations in the United States from 2001 through 2014. JAMA Ophthalmol. 2019;137:48–56.
Archer DB, Canavan YM. Contusional eye injuries: retinal and choroidal lesions. Aust J Ophthalmol. 1983;11:251–64.
Berlin R. Zur sogenannten Commotio retinae. Klin Monatsbl Augenheilkd. 1873;1:42–78.
Gass J. Stereoscopic atlas of macular diseases: diagnosis and treatment. St. Louis: Mosby; 1987.
Duke-Elder, S. System of ophthalmology, (1972).
Bastek JV, Foos RY, Heckenlively J. Traumatic pigmentary retinopathy. Am J Ophthalmol. 1981;92:621–4.
Cogan DG. Pseudoretinitis pigmentosa. Report of two traumatic cases of recent origin. Arch Ophthalmol. 1969;81:45–53.
Pulido JS, Blair NP. The blood-retinal barrier in Berlin’s edema. Retina. 1987;7:233–6.
Hart JC, Frank HJ. Retinal opacification after blunt non-perforating concussional injuries to the globe. A clinical and retinal fluorescein angiographic study. Trans Ophthalmol Soc U K. 1975;95:94–100.
Ismail R, Tanner V, Williamson TH. Optical coherence tomography imaging of severe commotio retinae and associated macular hole. Br J Ophthalmol. 2002;86:473–4.
Bradley JL, et al. Ultra-high-resolution optical coherence tomographic findings in commotio retinae. Arch Ophthalmol. 2011;129:107–8.
Sipperley JO, Quigley HA, Gass DM. Traumatic retinopathy in primates. The explanation of commotio retinae. Arch Ophthalmol. 1978;96:2267–73.
Eagling EM. Ocular damage after blunt trauma to the eye. Its relationship to the nature of the injury. Br J Ophthalmol. 1974;58:126–40.
Aaberg T. Macular holes. Surv Ophthalmol. 1970;15:162.
Miller JB, Yonekawa Y, Eliott D, Vavvas DG. A review of traumatic macular hole: diagnosis and treatment. Int Ophthalmol Clin. 2013;53:59–67.
Gass J. Stereoscopic atlas of macular diseases. St. Louis: Mosby; 1970.
Huang J, Liu X, Wu Z, Sadda S. Comparison of full-thickness traumatic macular holes and idiopathic macular holes by optical coherence tomography. Graefes Arch Clin Exp Ophthalmol. 2010;248:1071–5.
Johnson RN, et al. Traumatic macular hole: observations, pathogenesis, and results of vitrectomy surgery. Ophthalmology. 2001;108:853–7.
Kuhn F, Morris R, Mester V, Witherspoon CD. Internal limiting membrane removal for traumatic macular holes. Ophthalmic Surg Lasers. 2001;32:308–15.
Rubin JS, et al. Vitrectomy, fluid-gas exchange and transforming growth factor–beta-2 for the treatment of traumatic macular holes. Ophthalmology. 1995;102:1840–5.
Garcia-Arumi J, Corcostegui B, Cavero L, Sararols L. The role of vitreoretinal surgery in the treatment of posttraumatic macular hole. Retina. 1997;17:372–7.
Markham RH, Chignell AH. Retinal detachment due to macular holes. Br J Ophthalmol. 1981;65:423–4.
Aaberg TM, Blair CJ, Gass JD. Macular holes. Am J Ophthalmol. 1970;69:555–62.
Aguilar JP, Green WR. Choroidal rupture. A histopathologic study of 47 cases. Retina. 1984;4:269–75.
Graefe AV. Zwei Falle von Ruptur der Choroidia. Graefes Arch Ophthalmol. 1854;1:402.
Ament CS, et al. Predictors of visual outcome and choroidal neovascular membrane formation after traumatic choroidal rupture. Arch Ophthalmol. 2006;124:957–66.
Fuller B, Gitter KA. Traumatic choroidal rupture with late serous detachment of macula. Report of successful argon laser treatment. Arch Ophthalmol. 1973;89:354–5.
Harissi-Dagher M, et al. Photodynamic therapy in young patients with choroidal neovascularization following traumatic choroidal rupture. Am J Ophthalmol. 2005;139:726–8.
Elliot D. R.L.A. Issues in ocular trauma – nonpenetrating posterior segment trauma. Ophthalmol Clin North America. 1995;8:647–67.
Goldzieher W. Beitrag zur Pathologie der orbitalen Schussverletzungen. Z Augenh. 1901;6:277–85.
Asaria RH, Zaman A, Sullivan PM. Retinitis sclopeteria associated with airbag inflation. Br J Ophthalmol. 1999;83:1094–5.
Goerlitz-Jessen M, Ali MH, Grewal DS. Sclopetaria and spontaneous resolution of subretinal fluid. Ophthalmol Retina. 2019;3:325.
Martin DF, et al. Treatment and pathogenesis of traumatic chorioretinal rupture (sclopetaria). Am J Ophthalmol. 1994;117:190–200.
Richards RD, West CE, Meisels AA. Chorioretinitis sclopetaria. Trans Am Ophthalmol Soc. 1968;66:214–32.
Richards RD, West CE, Meisels AA. Chorioretinitis sclopetaria. Am J Ophthalmol. 1968;66:852–60.
Williams DF, Mieler WF, Williams GA. Posterior segment manifestations of ocular trauma. Retina. 1990;10(Suppl 1):S35–44.
Mungan NK. Update on shaken baby syndrome: ophthalmology. Curr Opin Ophthalmol. 2007;18:392–7.
Emerson MV, Jakobs E, Green WR. Ocular autopsy and histopathologic features of child abuse. Ophthalmology. 2007;114:1384–94.
Harley RD. Ocular manifestations of child abuse. J Pediatr Ophthalmol Strabismus. 1980;17:5–13.
Wilkinson WS, Han DP, Rappley MD, Owings CL. Retinal hemorrhage predicts neurologic injury in the shaken baby syndrome. Arch Ophthalmol. 1989;107:1472–4.
Harcourt B, Hopkins D. Permanent chorioretinal lesions in childhood of suspected origin. Trans Ophthalmol Soc U K. 1973;93:199–205.
Emerson MV, Pieramici DJ, Stoessel KM, Berreen JP, Gariano RF. Incidence and rate of disappearance of retinal hemorrhage in newborns. Ophthalmology. 2001;108:36–9.
Duane TD. Valsalva hemorrhagic retinopathy. Trans Am Ophthalmol Soc. 1972;70:298–313.
Markovits AS. Sudden visual loss associated with sexual activity. Arch Ophthalmol. 1996;114:106.
Ulbig MW, Mangouritsas G, Rothbacher HH, Hamilton AM, McHugh JD. Long-term results after drainage of premacular subhyaloid hemorrhage into the vitreous with a pulsed Nd:YAG laser. Arch Ophthalmol. 1998;116:1465–9.
Sahu DK, Namperumalsamy P, Kim R, Ravindran RD. Argon laser treatment for premacular hemorrhage. Retina (Philadelphia, PA). 1998;18:79–82.
De Terson A. l’hemorrhagie dans le corps vitre au cours de l’hemorrhagie cerebrale. Clin Ophthalmol. 1900;6:309.
Shaw HJ, Landers MB III, Sydnor CF. The significance of intraocular hemorrhages due to subarachnoid hemorrhage. Ann Ophthalmol. 1977;9:1403–5.
Khan SG, Frenkel M. Intravitreal hemorrhage associated with rapid increase in intracranial pressure (Terson’s syndrome). Am J Ophthalmol. 1975;80:37–43.
Muller PJ, Deck JH. Intraocular and optic nerve sheath hemorrhage in cases of sudden intracranial hypertension. J Neurosurg. 1974;41:160–6.
Toosi SH, Malton M. Terson’s syndrome–significance of ocular findings. Ann Ophthalmol. 1987;19:7–12.
Weingeist TA, Goldman EJ, Folk JC, Packer AJ, Ossoinig KC. Terson’s syndrome. Clinicopathologic correlations. Ophthalmology. 1986;93:1435–42.
Velikay M, et al. Retinal detachment with severe proliferative vitreoretinopathy in Terson syndrome. Ophthalmology. 1994;101:35–7.
Kuhn F, Morris R, Witherspoon CD, Mester V. Terson syndrome. Results of vitrectomy and the significance of vitreous hemorrhage in patients with subarachnoid hemorrhage. Ophthalmology. 1998;105:472–7.
Clarkson JG, Flynn HW Jr, Daily MJ. Vitrectomy in Terson’s syndrome. Am J Ophthalmol. 1980;90:549–52.
Schultz PN, Sobol WM, Weingeist TA. Long-term visual outcome in Terson syndrome. Ophthalmology. 1991;98:1814–9.
Morris R, Kuhn F, Witherspoon CD, Mester V, Dooner J. Hemorrhagic macular cysts in Terson’s syndrome and its implications for macular surgery. Dev Ophthalmol. 1997;29:44–54.
Purtscher O. Angiopathia retinae traumatica. Lymphorrhagien des Augengrundes. Graefes Arch Clin Exp Ophthalmol. 1912;82:347–71.
Burton TC. Unilateral Purtscher’s retinopathy. Ophthalmology. 1980;87:1096–105.
Miguel AI, Henriques F, Azevedo LF, Loureiro AJ, Maberley DA. Systematic review of Purtscher’s and Purtscher-like retinopathies. Eye (Lond). 2013;27:1–13.
Kelley JS. Purtscher’s retinopathy related to chest compression by safety belts. Fluorescein angiographic findings. Am J Ophthalmol. 1972;74:278–83.
Jacob HS, Craddock PR, Hammerschmidt DE, Moldow CF. Complement-induced granulocyte aggregation: an unsuspected mechanism of disease. N Engl J Med. 1980;302:789–94.
Urbanek J. Uber Fettembolie des Auges. Graefes Arch Clin Exp Ophthalmol. 1934;131:147–73.
Inkeles DM, Walsh JB. Retinal fat emboli as sequela to acute pancreatitis. Am J Ophthalmol. 1975;80:935–8.
Giani A, Deiro AP, Sabella P, Eandi CM. Spectral domain-optical coherence tomography and fundus autofluorescence findings in a case of purtscher-like retinopathy. Retin Cases Brief Rep. 2011;5:167–70.
Atabay C, Kansu T, Nurlu G. Late visual recovery after intravenous methylprednisolone treatment of Purtscher’s retinopathy. Ann Ophthalmol. 1993;25:330–3.
Wang AG, Yen MY, Liu JH. Pathogenesis and neuroprotective treatment in Purtscher’s retinopathy. Jpn J Ophthalmol. 1998;42:318–22.
Edwards P, et al. Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months. Lancet. 2005;365:1957–9.
Ahmed Y, Schimel AM, Pathengay A, Colyer MH, Flynn HW Jr. Endophthalmitis following open-globe injuries. Eye (Lond). 2012;26:212–7.
Bhagat N, Nagori S, Zarbin M. Post-traumatic infectious Endophthalmitis. Surv Ophthalmol. 2011;56:214–51.
Cunningham ET Jr, Kilmartin D, Agarwal M, Zierhut M. Sympathetic Ophthalmia. Ocul Immunol Inflamm. 2017;25:149–51.
Castiblanco CP, Adelman RA. Sympathetic ophthalmia. Graefes Arch Clin Exp Ophthalmol. 2009;247:289–302.
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Fan, J., Bagheri, N., Pieramici, D.J. (2020). Traumatic Maculopathy. In: Albert, D., Miller, J., Azar, D., Young, L.H. (eds) Albert and Jakobiec's Principles and Practice of Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-90495-5_120-1
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